I have a surgeon who is questioning why they do not get reimbursed 100% for both codes as they were performed with different approaches. Would insurances accept an appeal based on this or do we just have to accept the multiple procedure reduction on the second code? Thanks in advance for any answers.
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Tag Archives: Together
Can CPT 47562 and 49652 billed together?
PreOperative Diagnosis: Cholelithiasis, Biliary colic and Ventral incisional hernia
Post Op Diagnosis: Same
Procedure:
Robotic laparoscopic cholecystectomy followed by robotic laparoscopic ventral incisional hernia repair with mesh. There was a left lower quadrant hernia measuring 4 X 3 cm and infraumbilical hernia measuring 2 X 1 cm
I have check AAPC coder- no CCI edits.
Please help!!
Rupa
72100 and 72110 proper to bill together
I am reviewing a bill and trying to determine if it is proper to bill 72100 and 72110 together. Please advised
Coding a Medicare Wellness Exam & Complete Physical Together
I’m hoping someone can answer this because I am finding conflicting information in other post or on-line and there is a debate in our office with providers on how to do this. If a patient comes in for their Annual Medicare Exam (G0439) and request a physical as well how would you code both exams? Would you code it as G0439 with an E/M code plus modifier 25 or G0439 with an age preventive visit code with modifier 25?
Thank you,
Lisa
90471 and 90472 to code together or not to code together
When coding and billing for Dtap or Tdap without counseling for age 18 and under and for age 18 and above, what is the norm or the correct way to bill the insurance for this injection.
90471 + 90472 x2 or just bill for 90471 only?
What is the correct and the best practice in the industry?
Stitch Together the Pieces of Telehealth Rules
Payers vary on documentation and coding requirements for telehealth services. The rules for documenting and coding telehealth services are a patchwork. Guidelines for Medicare payers, although evolving, are well established. Private payer rules vary depending on the insurer, the patient’s individual plan, and the state where the services are rendered. Regardless of payer, you’ll need […]
AAPC Knowledge Center
[Announcement] NCCI Has Removed the Current Edit Prohibiting 77295 and 77300 from Being Reported Together
CMS and the NCCI has removed the current edit prohibiting the reporting of CPT codes 77295 and 77300 together, effective July 1, 2016. The change will be finalized in the July version of the NCCI Manual and will be retroactive to January 1, 2016. Reporting requirements may vary by payer:
Claims reported to Medicare contractors:
Claims for CPT codes 77295 and 77300 should not be reported together until the edit is removed on July 1, 2016. Practice billing systems can begin capturing charges for 77300; however, the charges should not be released to Medicare until July 1, 2016. All prospective and retrospective pending charges for 77300 may be released on or after July 1, 2016.
Claims reported to private payers:
Depending on state guidelines and individual payer policies, some private payers may not permit claims to be submitted after a certain period of time has passed. Therefore, practices could consider submitting charges for 77300 to commercial payers prior to July 1, 2016. Refer to your payer’s individual reporting policies for guidance on when to submit claims for 77295 and 77300.
Click here to read the original article on the prohibition of reporting 77295 and 77300 together.
The Medical Management Institute – MMI – Medical Coding News & MMI Updates
Provider is arguing that we can bill the following together
Procedure: Removal of pacemaker with replacement same session with addition lead placement
Provider is wanting us to bill 33233 and 33208 together but I feel it should be 33228 and 33216
Provider is wanting us to bill 33233 and 33208 together but I feel it should be 33228 and 33216
How would you code?
Using CPT codes 64718 and 24358 together
Hello all,
I am hoping someone can help me understand if there is a way that it is okay to use both 64718 and 24358 together during one surgery? :confused:
I am hoping someone can help me understand if there is a way that it is okay to use both 64718 and 24358 together during one surgery? :confused:
[Announcement] NCCI Will No Longer Allow 77300 and 77295 to be Reported Together
The 2016 National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services was released for services effective January 1, 2016. NCCI is a contractor for the Centers for Medicare and Medicaid Services (CMS) that aims to prevent improper payment when incorrect code combinations are reported.
Beginning January 1, 2016, NCCI will no longer allow the following CPT codes to be reported together:
77300: Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician.
77295: 3-dimensional radiotherapy plans, including dose-volume histograms.
CMS has implemented an edit on these codes because the agency believes the work of 77300 is integral to the work of 77295, and therefore is not considered a separately reportable procedure.
The Medical Management Institute – MMI – Medical Coding News & MMI Updates